CAJ | 학술논문

目的：探讨肝癌患者动脉化疗栓塞术后的自我管理效能感的现状和相关因素，为医务人员制定肝癌患者自我管理项目的内容提供依据。方法方便抽取2013年10月—2014年6月149例苏州和南通地区2家三级甲等医院住院的行肝动脉化疗栓塞术后的肝癌患者进行调查，发放调查问卷，应用一般资料调查表、中文版癌症患者自我管理效能感量表、肝癌患者生活质量评价量表、记忆症状评估量表和社会支持量表，进行单因素方差分析和多元逐步线性回归分析。结果肝癌患者的自我管理效能感总体处于中低水平，其中生活质量总分、介入治疗次数、生理症状、美国东部肿瘤协作组体能评分和社会支持总分共5个变量，是患者自我管理效能感总分的影响因素；生活质量总分、美国东部肿瘤协作组体能评分、介入治疗次数、生理症状、社会支持总分是正性态度维度的影响因素；生活质量总分、文化程度、白细胞值和有无接受健康培训是自我决策维度的影响因素；生活质量总分、有无接受健康培训状况和生理症状是自我减压维度的影响因素。结论肝动脉化疗栓塞术后肝癌患者自我管理效能感水平较低，各维度以及总自我管理效能感分别与不同的因素有关，医护人员应重视影响其自我管理效能感不同维度间的因素，为今后制定出适合肝癌患者自我管理项目的内容和措施提供理论依据。
목적：탐토간암환자동맥화료전새술후적자아관리효능감적현상화상관인소，위의무인원제정간암환자자아관리항목적내용제공의거。방법방편추취2013년10월—2014년6월149례소주화남통지구2가삼급갑등의원주원적행간동맥화료전새술후적간암환자진행조사，발방조사문권，응용일반자료조사표、중문판암증환자자아관리효능감량표、간암환자생활질량평개량표、기억증상평고량표화사회지지량표，진행단인소방차분석화다원축보선성회귀분석。결과간암환자적자아관리효능감총체처우중저수평，기중생활질량총분、개입치료차수、생리증상、미국동부종류협작조체능평분화사회지지총분공5개변량，시환자자아관리효능감총분적영향인소；생활질량총분、미국동부종류협작조체능평분、개입치료차수、생리증상、사회지지총분시정성태도유도적영향인소；생활질량총분、문화정도、백세포치화유무접수건강배훈시자아결책유도적영향인소；생활질량총분、유무접수건강배훈상황화생리증상시자아감압유도적영향인소。결론간동맥화료전새술후간암환자자아관리효능감수평교저，각유도이급총자아관리효능감분별여불동적인소유관，의호인원응중시영향기자아관리효능감불동유도간적인소，위금후제정출괄합간암환자자아관리항목적내용화조시제공이론의거。
Objective To explore the current status of self-care efficacy and correlated factors of primary hepatic carcinoma (PHC) patients by transcatheter arterial chemoembolization and to provide theoretical suggestions for PHC patient self-management program. Methods With convenience sampling in October 2013 - June 2014, 149 cases of PHC patients received questionnaire survey by general information questionnaire, Strategies Used by People to Promote Health(SUPPH), Quality of life-Liver cancer2.0(QOL-LC2.0), Memorial Symptom Assessment Scales (MSAS) and Social Support Scale and one-way analysis of variance and multiple regression analysis were carried on. Results The level of self-efficacy was low and moderate. Quality of life, interventional treatment times, physical symptoms, ECOG physical ability scores and social supports entered the model and were influencing factors of self-care efficacy. Quality of life, ECOG physical ability scores, interventional treatment times, physical symptoms, social support were the influencing factors of positive attitude. Quality of life, educational background, blood leukocyte value and with training on health or not were influencing factors of decision-making. Quality of life, with training on health or not and physical symptoms were the influencing factors of stress reduction. Conclusion The self-efficacy of self-management of PHC patients by transcatheter arterial chemoembolization is low and scores different dimensions and the total scores relate respectively to different factors. Great importance should be attached to the influence factors to make quality self-management program for PHC patients in the future .